The PPACA Thread Part III - Let's have a healthy debate!

[ScoobyDoo]

Re: The PPACA Thread Part III - Let's have a healthy debate!

The only fix for healthcare is capitalist purity.

[JF_Gophers]

The only fix for healthcare is capitalist purity.

Come to Jimbo's $29.95 colonoscopy sale. Lowest price in town or your 2nd visits free!

[dxmnkd316]

Re: The PPACA Thread Part III - Let's have a healthy debate!

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Suck a massive dick CEBro

http://gawker.com/heroic-uhhh-pharma...rcu-1738185665

[FadeToBlack&Gold]

Re: The PPACA Thread Part III - Let's have a healthy debate!

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Suck a massive dick CEBro

http://gawker.com/heroic-uhhh-pharma...rcu-1738185665

Gawker = grain of salt. There is literally no such thing as a "heroic" pharma. They would not be doing this if it wasn't all about the Benjamins.

Sorry, but you are delusional if you think this is an altruistic move. They've done the math, and they are merely undercutting the competition. I would too, in their shoes.

[dxmnkd316]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Don't think I said that.

[FreshFish]

Re: The PPACA Thread Part III - Let's have a healthy debate!

But isn't that true of health care before? That about 80% of the costs came from 20% of the people?

That's a good rule of thumb for any insurance, and that's the whole point of insurance in the first place, generally speaking (the numbers might vary, for term life insurance for example 100% of the claims come from 1% of those insured).

The difference for people with chronic conditions is significant. "Insurance" spreads risk in the face of uncertainty: on the individual level, maybe something will trigger a claim, and maybe it won't; yet on the collective level, somewhere a certain number of claims is inevitable.

However, for people with chronic conditions, there is no uncertainty: we know for sure that they will have healthcare costs to treat those chronic conditions. The rational, practical response is to place those people into a so-called "special risk" pool so that their healthcare costs are covered differently than those who are traditionally insured under the risk-spread paradigm.

Unfortunately, the designers of PPACA somehow believed that the intensity of their fervent good intentions would cause reality to bow down before them. They mingled people with chronic conditions back into the general population again, with totally predictable and expected results.

When the states managed special-risk pools, they would overtly use general taxpayer funds to subsidize healthcare for people with chronic conditions, and most taxpayers were okay with that: it was humanitarian, and clearly identifiable and understandable how much money was being used where for what.

PPACA architects tried to fool people by disguising cross-subsidies, and, well, basically telling people things that weren't true. It took awhile, but now people are starting to see through the gauzy fairy tales that were spun at the outset to see how things really are working now. Once that happens, the funding instability only worsens.

It is only "insurance" when there is uncertainty and risk. Once certainty enters the equation, everything is thrown out of balance.




Here's an analogy that might help. Most people who own a home has homeowner's insurance that covers loss in event of a fire. Suppose that some people cannot afford homeowner's insurance, yet they were allowed to purchase homeowner's insurance retroactively after they had already suffered through a fire; and the costs of those claims was to be spread over all other homeowners' policies. The premiums on those policies would go up substantially, and many of those people who previously could have afforded homeowner's insurance now could no longer afford it. As they start to drop their policies, there are fewer people left insured, so that those premiums have to go up even more. Repeat the cycle. Repeat again. You have a really big mess on your hands. A mess that easily could be avoided merely by helping people who suffered a fire through direct payments from another source rather than try to finagle them into insurance retroactively.

[FreshFish]

Re: The PPACA Thread Part III - Let's have a healthy debate!

If healthcare cost less than sick people would cost less. Then insurance could cost less as well. Everyone wins, except those who are trying to make money.

If people are sick before they are covered, then it is no longer insurance when you do provide assistance to them to pay for medical care.


A certain amount of what we call "health insurance" today is merely forced savings: if a routine checkup is covered by "insurance" then a portion of the premium actually is collecting money from you that you could have saved on your own instead. "Insurance" does not cover certainty, and a routine checkup is certain; hence "coverage" for a routine checkup is not "insurance" it is disguised pre-paid savings. We could accomplish the same thing by excluding routine checkups from "insurance" and combining "insurance" with a tax-free savings account that people could draw upon for predictable budgetable events. That would probably be a really effective way to help hold down healthcare costs, because then people would realize that their routine checkup actually costs $350 not just $15 copay.

[unofan]

Re: The PPACA Thread Part III - Let's have a healthy debate!

If people are sick before they are covered, then it is no longer insurance when you do provide assistance to them to pay for medical care.

A certain amount of what we call "health insurance" today is merely forced savings: if a routine checkup is covered by "insurance" then a portion of the premium actually is collecting money from you that you could have saved on your own instead. "Insurance" does not cover certainty, and a routine checkup is certain; hence "coverage" for a routine checkup is not "insurance" it is disguised pre-paid savings. We could accomplish the same thing by excluding routine checkups from "insurance" and combining "insurance" with a tax-free savings account that people could draw upon for predictable budgetable events. That would probably be a really effective way to help hold down healthcare costs, because then people would realize that their routine checkup actually costs $350 not just $15 copay.

And screw poor people. Why do they need healthcare, anyway? Not to mention dis-incentivizing going to the doctor early, when a routine course of penicillin might be all that's needed, and waiting until you get really, really sick and it costs 100x as much to cure.

[JF_Gophers]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Savings accounts for healthcare are popular now. But I have zero interest in them.

If the insurance company wants to run it like savings they can. But don't put it on me to have to manage it.

I go to the doctor, insurance pays. No other steps should be involved.

[FadeToBlack&Gold]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Savings accounts for healthcare are popular now. But I have zero interest in them.

If the insurance company wants to run it like savings they can. But don't put it on me to have to manage it.

I go to the doctor, insurance pays. No other steps should be involved.

I use the HSA to cover co-pays, and routine things that are not covered by insurance, such as contact lenses.

They send you a debit card, you use that to pay at the doctor's office, and usually you're done. Occasionally, they ask you to submit the EOB. It's not a huge deal.

It's not that much different from budgeting for these expenses each year, and you get to do it with pre-tax money.

[FreshFish]

Re: The PPACA Thread Part III - Let's have a healthy debate!

And screw poor people. Why do they need healthcare, anyway? Not to mention dis-incentivizing going to the doctor early, when a routine course of penicillin might be all that's needed, and waiting until you get really, really sick and it costs 100x as much to cure.

that's a really short-sighted, emotion-laden, narrow-minded, unthinking reply.

I was speaking in hypotheticals about different possibilities, not making any one particular policy proposal, and even within the hypothetical I just offered, it would be far more effective to give poor people a pre-paid healthcare debit card to use to cover doctors' visits and co-pays than the thoroughly messed up system that we are stuck with now. Or did you overlook the part about "special-risk pools covered by state expenditures" in your zeal to demonstrate how compassionate you are?

[FreshFish]

Re: The PPACA Thread Part III - Let's have a healthy debate!

I use the HSA to cover co-pays, and routine things that are not covered by insurance, such as contact lenses.

They send you a debit card, you use that to pay at the doctor's office, and usually you're done. Occasionally, they ask you to submit the EOB. It's not a huge deal.

It's not that much different from budgeting for these expenses each year, and you get to do it with pre-tax money.

and with HSAs, unlike FSAs, you get to roll over the money each year. It's a great concept, since by accumulating more money in the HSA you can then afford to move to higher-deductible plans over, saving money, and also build up a fund to help with your own eldercare expenses for your later years. People moan about how costly it is to provide healthcare to seniors, why not incentivize people to start saving now to be able to afford some of that cost later?

[JF_Gophers]

and with HSAs, unlike FSAs, you get to roll over the money each year. It's a great concept, since by accumulating more money in the HSA you can then afford to move to higher-deductible plans over, saving money, and also build up a fund to help with your own eldercare expenses for your later years. People moan about how costly it is to provide healthcare to seniors, why not incentivize people to start saving now to be able to afford some of that cost later?

Or start shortening the human lifespan. If we don't get old, there won't be as many healthcare costs.

[St. Clown]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Or start shortening the human lifespan. If we don't get old, there won't be as many healthcare costs.

The tobacco companies tried that argument, but the judges through it out in court.

[JF_Gophers]

The tobacco companies tried that argument, but the judges through it out in court.

They failed but fast food and alcohol is succeeding.